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Nursing and the March of Dimes: An historical summary

by David Rose, March of Dimes Archivist

The March of Dimes was founded as the National Foundation for Infantile Paralysis (NFIP) in 1938 to lead the fight against polio just as polio epidemics began to increase in severity. One of the first problems the new foundation faced during the World War II years was shortages of trained medical personnel, especially nurses. March of Dimes President Basil O'Connor immediately saw the need to support nursing education to correct this shortfall, and he joined the Advisory Council on Orthopedic Nursing of the National Organization for Public Health Nursing to forge a partnership that had a wide-ranging effect. NFIP grants for nursing consultants in epidemics, scholarships for nursing education, and a manual for orthopedic nursing care followed. In 1940, the publication of Nursing Care of Patients with Infantile Paralysis by Jessie Stevenson, RN, alone was a vital step in rallying the nursing profession to the forefront in the fight against polio.

Grants for nursing education at university centers throughout the nation became an integral feature of the March of Dimes professional education program. Dr. Catherine Worthingham, Director of Professional Education, oversaw the coordination of educational programs relating to physical therapy in its relation to fields such as nursing. The foundation collaborated with the National Organization for Public Health Nursing to empower the Joint Orthopedic Nursing Advisory Service (JONAS), which coordinated in-service training with epidemic relief in response to polio emergencies. In 1946, the March of Dimes created the Polio Emergency Volunteers (PEVs) to train volunteer assistants to help nurses and physical therapists in the bedside care of patients with paralytic polio. The NFIP and American Red Cross together adopted procedures for emergency nursing service that set standards in recruitment, qualifications, terms of employment, salaries and per diem payments of registered nurses to ensure nationwide uniformity of the treatment of nurses in polio epidemics.

In addition to its contributions to these important developments to post-war nursing professionalization, the NFIP recruited more than 10,000 nurses during the period 1946 to 1951. In the Salk polio vaccine field trial organized by the NFIP in 1954, more than 40,000 nurses participated as volunteers. A Nursing Advisory Committee of the NFIP was created the following year to review nursing problems and resources; though the committee was short-lived, it played a vital role in formulating how polio respiratory centers created with March of Dimes funds were to be utilized in nursing education. By the end of the polio era, the NFIP had funded the National League of Nursing alone more than $2 million to improve the quality of care for polio patients and others. This investment was over and above the many sizeable individual grants for nursing education at colleges and universities, including African-American institutions such as the Tuskegee Institute.

By the 1960s, as polio declined rapidly in response to the new vaccines, the March of Dimes renewed its commitment to the nursing profession by announcing a 10-year, $12 million college scholarship program that included nursing as one of five fields relevant to its new mission of birth defects prevention. During a decade of transition, the foundation began to re-orient its new mission from a clinical model of birth defects to a more encompassing perspective on perinatal health. With the announcement in 1972 that a shift in focus to maternal and child health had re-aligned its mission within the field of perinatology, the Foundation helped to establish the Committee on Perinatal Health which published recommendations in 1976 for the regionalization of perinatal health care in Toward Improving the Outcome of Pregnancy. The shift in approach had an immediate and profound implication for nursing. Dr. Mitzi Duxbury, Assistant Director for Nursing Service and Education, organized a meeting at the University of Wisconsin School of Nursing to initiate plans for the development of training programs to improve the skills of nurses who provide care to mothers and infants. The meeting led to a pilot test of training modules on the physical assessment and care of the newborn. Thus, just at the time the Committee on Perinatal Health deliberated on the issue of regionalization, Dr. Duxbury led the initiative to create a continuing education program for nurses. The centerpiece of the new development was the nursing module program.

March of Dimes nursing modules launched in 1975 are a series of training booklets for the continuing education of nurses in the field of perinatal health on the care of pregnant women and newborn infants, designed for both group instruction and independent study. March of Dimes is an approved provider of continuing education by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. The modules are written by nurses for nurses and have been widely utilized in nursing education in hospitals, nursing schools, prenatal clinics and public health agencies. The modules have covered key topics in neonatal clinical care and contemporary issues in nursing such as adolescent pregnancy, diabetes, multiple births, and obstetrical emergencies as well as issues in ethics and genetics. The program provides the most up-to-date information on nursing practice, assessment of risk, care of the client and provision of care in normal and emergency situations.

Beverly S. Raff succeeded Dr. Duxbury as the head of professional education, and in 1993 the Foundation established a National Nurse Advisory Council with oversight over the nursing module program. Dr. Margaret Comerford Freda served as the first chairperson of the council. During the evolution of the nursing module program, the March of Dimes has sought to improve its support to the profession by sponsoring perinatal nursing conferences and nursing grand rounds, establishing scholarships and awards, and forging mutually helpful collaborations with organizations such as the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), the American College of Nurse-Midwives (ACNM) and the National Association of Neonatal Nurses NANN. In 1998, the Foundation established an annual Graduate Nursing Scholarship to assist registered nurses enrolled in graduate programs in maternal-child nursing. The Nurse Advisory Council continues to give critical guidance to the Foundation on nursing issues relating to its Prematurity Campaign as the reach of the nursing module program has expanded to online versions. The March of Dimes investment in the nursing profession has become a collaborative model of how to achieve excellence in nursing leadership and education.